ACORD 276 Instructions


Section Name Field Name Field and/or Section Description
TITLE ACORD 276 (2009/05) Aircraft Insurance Binder The title of the form. ACORD 276, Aircraft Insurance Binder, addresses both Personal Lines and Commercial Lines Aircraft risks. Before issuing any binder, the following important considerations should be reviewed and considered carefully: * A Binder (Cover Note in some states) is a temporary insurance contract which provides coverage in advance of the issuance of aninsurance policy. * The improper use of binders has become a major cause of producer’s Errors and Omissions claims. It is imperative that only authorized people prepare them. Preparation must be complete and accurate. * All binders must conform to the state insurance code for the state in which the subject of insurance in located. * The maximum and/or minimum term of a binder may be governed by state statute and/or company underwriting instructions. * At the end of the binder’s specified term, all coverage expires unless a new binder has been issued or the expired binder has been replaced with a policy .
TITLE * The language in the binder must be precise. Do not use vague or all-encompassing terms which may imply coverages not intended, such as “All Risk.” If possible, use the same language and terminology that will appear on policy. * An agent may only issue binders which comply with the company’s underwriting instructions (per company manual, agency agreement, correspondence and/or company underwriter). If the authority is not in writing, the agent should obtain written authority. Most agency agreements contain stated “time frames” within which the company must be notified of any risk bound. * Generally, a broker cannot bind insurance. A broker may only exercise the authority extended by the company. It is recommended that individual binders be issued for each company affording coverage.

ACORD 276 (2009/05) 1 of 13

 

Section Name Field Name Field and/or Section Description
TITLE * Most agency agreements dealing with surplus lines and specialty market contracts do not allow the agent or broker to bind coverage. Authorization must be secured prior to binding. * A binder provides coverage for a specified period. In most jurisdictions, a premium must be charged for this period unless the binder is replaced by a policy. A deposit should be obtained when issuing a binder. A deposit premium may be required by some companies. * Most companies prohibit issuing or extending binders where coverage has been refused or cancelled by any carrier.
IDENTIFICATION SECTION Date (MM/DD/YYYY) Enter date: The month/day/year on which the form is completed. (MM/DD/YYYY)
IDENTIFICATION SECTION Agency Enter text: The full name of the producer/agency.
IDENTIFICATION SECTION Enter text: The mailing address line one of the producer/agency.
IDENTIFICATION SECTION Enter text: The mailing address line two of the producer/agency.
IDENTIFICATION SECTION Enter text: The mailing address city name of the producer/agency.
IDENTIFICATION SECTION Enter code: The mailing address state or province code of the producer/agency.
IDENTIFICATION SECTION Enter code: The mailing address postal code of the producer/agency.
IDENTIFICATION SECTION Contact Name Enter text: The name of the individual at the producer’s establishment that is the primary contact.
IDENTIFICATION SECTION Phone (A/C, No, Ext) Enter number: The producer’s contact person’s phone number. If applicable, include the area code and extension.
IDENTIFICATION SECTION Fax No. (A/C, No) Enter number: The fax number of the producer/agency.
IDENTIFICATION SECTION Code Enter code: The identification code assigned to the producer (e.g. agency or brokerage firm) by the insurer.
IDENTIFICATION SECTION Sub Code Enter code: The identification code assigned by the insurer to the sub-producer (e.g. person) within a producer’s office (e.g. agency or brokerage).
IDENTIFICATION SECTION Agency Customer Id Enter identifier: The customer’s identification number assigned by the producer (e.g. agency or brokerage).
 

Section Name Field Name Field and/or Section Description
IDENTIFICATION SECTION Name & Mailing Address Enter text: The named insured(s) as it/they will appear on the policy declarations page.
IDENTIFICATION SECTION Enter text: The named insured’s mailing address line one.
IDENTIFICATION SECTION Enter text: The named insured’s mailing address line two.
IDENTIFICATION SECTION Enter text: The named insured’s mailing address city name.
IDENTIFICATION SECTION Enter code: The named insured’s mailing address state or province code.
IDENTIFICATION SECTION Enter code: The named insured’s mailing address postal code.
IDENTIFICATION SECTION Carrier Enter text: The insurer’s full legal company name(s) as found in thefile copy of the policy. Use the actual name of the company within the group to which the policy has been issued. This is not the insurer’s group name or trade name.
IDENTIFICATION SECTION NAIC Code Enter code: The identification code assigned to the insurer by the NAIC.
IDENTIFICATION SECTION Binder # Enter identifier: The number assigned to uniquely identify the binder.
IDENTIFICATION SECTION Effective Date Enter date: The date on which the terms and conditions of the binder commenced. This date normally coincides with the effective date of the policy or of an endorsement to the policy.
IDENTIFICATION SECTION Effective Time Enter time: The time of the binder effective date that the binder becomes effective.
IDENTIFICATION SECTION Effective Time AM Check the box (if applicable): Indicates the binder effective time is in the morning (AM).
IDENTIFICATION SECTION Effective Time PM Check the box (if applicable): Indicates the binder effective time is in the afternoon or evening (PM).
IDENTIFICATION SECTION Expiration Date Enter date: The date on which the terms and conditions of the policy will or have expired. Certain state laws limit the terms of a binder, so this date may not coincide with the policy expiration date.
IDENTIFICATION SECTION Expiration Time 12:01 AM Check the box (if applicable): Indicates the binder expires at 12:01 AM on the expiration date.
IDENTIFICATION SECTION Expiration Time Noon Check the box (if applicable): Indicates the binder expires at 12:00 noon on the expiration date.
 

Section Name Field Name Field and/or Section Description
IDENTIFICATION SECTION This binder is issued to extend coverage Checkbox Check the box (if applicable): Indicates the binder is issued to extend coverage on a policy where renewal is not yet available.
IDENTIFICATION SECTION Expiring Policy # Enter identifier: The policy number of the policy that is expiring.
POLICY INFORMATION Industrial Aid Check the box (if applicable): Indicates the type of policy is aircraft – industrial aid.
POLICY INFORMATION Pleasure & Business Check the box (if applicable): Indicates the type of policy is aircraft – pleasure and business.
POLICY INFORMATION Commercial Check the box (if applicable): Indicates the type of policy is aircraft – commercial.
POLICY INFORMATION Non-Owned Check the box (if applicable): Indicates the type of policy is aircraft – non-owned.
POLICY INFORMATION Other Checkbox Check the box (if applicable): Indicates the type of policy/perils insured is other than those listed.
POLICY INFORMATION Other Description Enter text: The description of the type of policy issued to the insured.
POLICY INFORMATION Airplane Check the box (if applicable): Indicates Airplane is the line of business subcode that further refines the line of business code.
POLICY INFORMATION Helicopter Check the box (if applicable): Indicates Helicopter is the line of business subcode that further refines the line of business code.
POLICY INFORMATION Mixed Fleet Check the box (if applicable): Indicates Mixed Fleet is the line of business subcode that further refines the line of business code.
POLICY INFORMATION Excess Check the box (if applicable): Indicates Excess is the line of business subcode that further refines the line of business code.
POLICY INFORMATION Quota Share Check the box (if applicable): Indicates Quota Share is the line of business subcode that further refines the line of business code.
POLICY INFORMATION Liability Only Check the box (if applicable): Indicates Liability Only is the line of business subcode that further refines the line of business code.
POLICY INFORMATION Hull & Liability Check the box (if applicable): Indicates Hull & Liability is the line of business subcode that further refines the line of business code.
POLICY INFORMATION Hull Only Check the box (if applicable): Indicates Hull Only is the line of business subcode that further refines the line of business code.
POLICY INFORMATION Other Checkbox Check the box (if applicable): Indicates the line of business subcode that further refines the line of business code is other than those listed.
POLICY INFORMATION Other Description Enter text: The line of business subcode that further refines the line of business code.
AIRCRAFT INFORMATION ACORD 333, Aircraft Schedule Attached Check the box (if applicable): Indicates an ACORD 333, Aircraft Schedule, is attached to the certificate.
AIRCRAFT INFORMATION Year Enter year: The year of the aircraft.
AIRCRAFT INFORMATION Make Enter text: The manufacturer of the aircraft.
 

Section Name Field Name Field and/or Section Description
AIRCRAFT INFORMATION Model Enter text: The model of the aircraft.
AIRCRAFT INFORMATION Serial Number Enter identifier: The serial number of the aircraft.
AIRCRAFT INFORMATION Registration Number Enter identifier: The registration number of the aircraft (a.k.a. tail number).
AIRCRAFT INFORMATION Territory Enter text: The description of the rating territory for the aircraft.
AIRCRAFT COVERAGES Aircraft Hull Valuation Agreed Amount Check the box (if applicable): Indicates the type of value used in determining the limit of insurance is the agreed amount.
AIRCRAFT COVERAGES Aircraft Hull Valuation Insured Amount Check the box (if applicable): Indicates the type of value used in determining the limit of insurance is the insured amount.
AIRCRAFT COVERAGES Aircraft Hull Option Checkbox Check the box (if applicable): Indicates a coverage option applies to the coverage.
AIRCRAFT COVERAGES Aircraft Hull Option Description Enter text: The description of the option being requested. Examples: All Risk Ground and Flight, Ground and Taxi, Ground Not in Flight, Ground Not in Motion, Ground Only, In Motion Excluding Flight, Excluding in Flight, Aircraft Storage in Hangar.
AIRCRAFT COVERAGES Aircraft Hull Option Checkbox Check the box (if applicable): Indicates a coverage option applies to the coverage.
AIRCRAFT COVERAGES Aircraft Hull Option Description Enter text: The description of the option being requested. Examples: All Risk Ground and Flight, Ground and Taxi, Ground Not in Flight, Ground Not in Motion, Ground Only, In Motion Excluding Flight, Excluding in Flight, Aircraft Storage in Hangar.
AIRCRAFT COVERAGES Aircraft Hull Option Checkbox Check the box (if applicable): Indicates a coverage option applies to the coverage.
AIRCRAFT COVERAGES Aircraft Hull Option Description Enter text: The description of the option being requested. Examples: All Risk Ground and Flight, Ground and Taxi, Ground Not in Flight, Ground Not in Motion, Ground Only, In Motion Excluding Flight, Excluding in Flight, Aircraft Storage in Hangar.
AIRCRAFT COVERAGES Aircraft Hull Option Checkbox Check the box (if applicable): Indicates a coverage option applies to the coverage.
AIRCRAFT COVERAGES Aircraft Hull Option Description Enter text: The description of the option being requested. Examples: All Risk Ground and Flight, Ground and Taxi, Ground Not in Flight, Ground Not in Motion, Ground Only, In Motion Excluding Flight, Excluding in Flight, Aircraft Storage in Hangar.
AIRCRAFT COVERAGES Aircraft Hull Limit Enter limit: The limit amount for aircraft hull coverage.
AIRCRAFT COVERAGES Aircraft Hull Limit Applies To Enter code: The code identifying what the limit applies to. Examples: Total Aircraft, Aircraft while on Floats, Aircraft while on Skis, Floats, Skis.
AIRCRAFT COVERAGES Aircraft Hull Limit Enter limit: The limit amount for aircraft hull coverage.
AIRCRAFT COVERAGES Aircraft Hull Limit Applies To Enter code: The code identifying what the limit applies to. Examples: Total Aircraft, Aircraft while on Floats, Aircraft while on Skis, Floats, Skis.
AIRCRAFT COVERAGES Aircraft Hull Limit Enter limit: The limit amount for aircraft hull coverage.
 

Section Name Field Name Field and/or Section Description
AIRCRAFT COVERAGES Aircraft Hull Limit Applies To Enter code: The code identifying what the limit applies to. Examples: Total Aircraft, Aircraft while on Floats, Aircraft while on Skis, Floats, Skis.
AIRCRAFT COVERAGES Aircraft Hull Deductible Enter deductible: The deductible amount for aircraft hull coverage.
AIRCRAFT COVERAGES Aircraft Hull Deductible Applies To Enter code: The code identifying what the deductible applies to. Examples: All Other, Collision Deductible, Comprehensive Deductible, Each Engine, Each Claim, Each and Every Loss, Each Item, Each Tool, Ground Equipment, In Motion, Landing Gear Collapse / Gear Up Landing, Non-Scheduled Equipment, Not In Flight, Not In Motion, Not In Motion While Hangared, All Other Claims, Each Aircraft, Property Damage Deductible, Each Occurrence, Rotors In Motion, Rotors Not In Motion, Scheduled Equipment.
AIRCRAFT COVERAGES Aircraft Hull Deductible Enter deductible: The deductible amount for aircraft hull coverage.
AIRCRAFT COVERAGES Aircraft Hull Deductible Applies To Enter code: The code identifying what the deductible applies to. Examples: All Other, Collision Deductible, Comprehensive Deductible, Each Engine, Each Claim, Each and Every Loss, Each Item, Each Tool, Ground Equipment, In Motion, Landing Gear Collapse / Gear Up Landing, Non-Scheduled Equipment, Not In Flight, Not In Motion, Not In Motion While Hangared, All Other Claims, Each Aircraft, Property Damage Deductible, Each Occurrence, Rotors In Motion, Rotors Not In Motion, Scheduled Equipment.
AIRCRAFT COVERAGES Aircraft Hull Deductible Enter deductible: The deductible amount for aircraft hull coverage.
AIRCRAFT COVERAGES Aircraft Hull Deductible Applies To Enter code: The code identifying what the deductible applies to. Examples: All Other, Collision Deductible, Comprehensive Deductible, Each Engine, Each Claim, Each and Every Loss, Each Item, Each Tool, Ground Equipment, In Motion, Landing Gear Collapse / Gear Up Landing, Non-Scheduled Equipment, Not In Flight, Not In Motion, Not In Motion While Hangared, All Other Claims, Each Aircraft, Property Damage Deductible, Each Occurrence, Rotors In Motion, Rotors Not In Motion, Scheduled Equipment.
AIRCRAFT COVERAGES Aircraft Liability Option Checkbox Check the box (if applicable): Indicates a coverage option applies to the coverage.
AIRCRAFT COVERAGES Aircraft Liability Option Description Enter text: The description of the option being requested. Examples: Adjacent Fields/CBT, BI Only, Chemical BI, Chemical BI and PD, Chemical PD, CSL BI and PD, CSL BI and PD Excluding Passengers, CSL BI and PD Including Passengers, Excluding Chemicals, PD Only, Total Limit.
AIRCRAFT COVERAGES Aircraft Liability Option Checkbox Check the box (if applicable): Indicates a coverage option applies to the coverage.
 

Section Name Field Name Field and/or Section Description
AIRCRAFT COVERAGES Aircraft Liability Option Description Enter text: The description of the option being requested. Examples: Adjacent Fields/CBT, BI Only, Chemical BI, Chemical BI and PD, Chemical PD, CSL BI and PD, CSL BI and PD Excluding Passengers, CSL BI and PD Including Passengers, Excluding Chemicals, PD Only, Total Limit.
AIRCRAFT COVERAGES Aircraft Liability Option Checkbox Check the box (if applicable): Indicates a coverage option applies to the coverage.
AIRCRAFT COVERAGES Aircraft Liability Option Description Enter text: The description of the option being requested. Examples: Adjacent Fields/CBT, BI Only, Chemical BI, Chemical BI and PD, Chemical PD, CSL BI and PD, CSL BI and PD Excluding Passengers, CSL BI and PD Including Passengers, Excluding Chemicals, PD Only, Total Limit.
AIRCRAFT COVERAGES Aircraft Liability Option Checkbox Check the box (if applicable): Indicates a coverage option applies to the coverage.
AIRCRAFT COVERAGES Aircraft Liability Option Description Enter text: The description of the option being requested. Examples: Adjacent Fields/CBT, BI Only, Chemical BI, Chemical BI and PD, Chemical PD, CSL BI and PD, CSL BI and PD Excluding Passengers, CSL BI and PD Including Passengers, Excluding Chemicals, PD Only, Total Limit.
AIRCRAFT COVERAGES Aircraft Liability Each Occurrence Enter limit: The each occurrence limit amount for aircraft liability coverage.
AIRCRAFT COVERAGES Aircraft Liability Each Passenger Enter limit: The each passenger limit amount for aircraft liability coverage.
AIRCRAFT COVERAGES Aircraft Liability Each Person Enter limit: The each person limit amount for aircraft liability coverage.
AIRCRAFT COVERAGES Aircraft Liability Aggregate Enter limit: The aggregate limit amount for aircraft liability coverage.
AIRCRAFT COVERAGES Aircraft Liability Deductible Enter deductible: The deductible amount for aircraft liability coverage.
AIRCRAFT COVERAGES Aircraft Liability Deductible Applies To Enter code: The code identifying what the deductible applies to. Examples: All Other, Collision Deductible, Comprehensive Deductible, Each Engine, Each Claim, Each and Every Loss, Each Item, Each Tool, Ground Equipment, In Motion, Landing Gear Collapse / Gear Up Landing, Non-Scheduled Equipment, Not In Flight, Not In Motion, Not In Motion While Hangared, All Other Claims, Each Aircraft, Property Damage Deductible, Each Occurrence, Rotors In Motion, Rotors Not In Motion, Scheduled Equipment.
AIRCRAFT COVERAGES Aircraft Liability Deductible Enter deductible: The deductible amount for aircraft liability coverage.
 

Section Name Field Name Field and/or Section Description
AIRCRAFT COVERAGES Aircraft Liability Deductible Applies To Enter code: The code identifying what the deductible applies to. Examples: All Other, Collision Deductible, Comprehensive Deductible, Each Engine, Each Claim, Each and Every Loss, Each Item, Each Tool, Ground Equipment, In Motion, Landing Gear Collapse / Gear Up Landing, Non-Scheduled Equipment, Not In Flight, Not In Motion, Not In Motion While Hangared, All Other Claims, Each Aircraft, Property Damage Deductible, Each Occurrence, Rotors In Motion, Rotors Not In Motion, Scheduled Equipment.
AIRCRAFT COVERAGES Medical Payments Including Crew Check the box (if applicable): Indicates the crew is included in the medical payments coverage.
AIRCRAFT COVERAGES Medical Payments Excluding Crew Check the box (if applicable): Indicates the crew is excluded from the medical payments coverage.
AIRCRAFT COVERAGES Medical Payments Each Person Enter limit: The each person limit amount for medical payments coverage.
AIRCRAFT COVERAGES Coverage Code Enter code: The code for the coverage.
AIRCRAFT COVERAGES Coverage Description Enter text: The description of other coverage (not the limit) on the policy. Any questions about appropriate limits or applicable policy coverage(s) should be answered by the issuing insurer(s)
AIRCRAFT COVERAGES Option Checkbox Check the box (if applicable): Indicates a coverage option applies to the coverage.
AIRCRAFT COVERAGES Option Description Enter text: The description of the option being requested.
AIRCRAFT COVERAGES Option Checkbox Check the box (if applicable): Indicates a coverage option applies to the coverage.
AIRCRAFT COVERAGES Option Description Enter text: The description of the option being requested.
AIRCRAFT COVERAGES Option Checkbox Check the box (if applicable): Indicates a coverage option applies to the coverage.
AIRCRAFT COVERAGES Option Description Enter text: The description of the option being requested.
AIRCRAFT COVERAGES Limit Enter limit: The limit amount for the coverage.
AIRCRAFT COVERAGES Applies To Enter code: The code identifying what the limit applies to (i.e. per occurrence).
AIRCRAFT COVERAGES Limit Enter limit: The limit amount for the coverage.
AIRCRAFT COVERAGES Applies To Enter code: The code identifying what the limit applies to (i.e. per occurrence).
AIRCRAFT COVERAGES Limit Enter limit: The limit amount for the coverage.
AIRCRAFT COVERAGES Applies To Enter code: The code identifying what the limit applies to (i.e. per occurrence).
AIRCRAFT COVERAGES Deductible Enter deductible: The deductible amount for the coverage.
AIRCRAFT COVERAGES Applies To Enter code: The code identifying what the deductible applies to.
AIRCRAFT COVERAGES Deductible Enter deductible: The deductible amount for the coverage.
AIRCRAFT COVERAGES Applies To Enter code: The code identifying what the deductible applies to.
AIRCRAFT COVERAGES Deductible Enter deductible: The deductible amount for the coverage.
AIRCRAFT COVERAGES Applies To Enter code: The code identifying what the deductible applies to.
AIRCRAFT COVERAGES Coverage Code Enter code: The code for the coverage.
 

Section Name Field Name Field and/or Section Description
AIRCRAFT COVERAGES Coverage Description Enter text: The description of other coverage (not the limit) on the policy. Any questions about appropriate limits or applicable policy coverage(s) should be answered by the issuing insurer(s)
AIRCRAFT COVERAGES Option Checkbox Check the box (if applicable): Indicates a coverage option applies to the coverage.
AIRCRAFT COVERAGES Option Description Enter text: The description of the option being requested.
AIRCRAFT COVERAGES Option Checkbox Check the box (if applicable): Indicates a coverage option applies to the coverage.
AIRCRAFT COVERAGES Option Description Enter text: The description of the option being requested.
AIRCRAFT COVERAGES Option Checkbox Check the box (if applicable): Indicates a coverage option applies to the coverage.
AIRCRAFT COVERAGES Option Description Enter text: The description of the option being requested.
AIRCRAFT COVERAGES Limit Enter limit: The limit amount for the coverage.
AIRCRAFT COVERAGES Applies To Enter code: The code identifying what the limit applies to (i.e. per occurrence).
AIRCRAFT COVERAGES Limit Enter limit: The limit amount for the coverage.
AIRCRAFT COVERAGES Applies To Enter code: The code identifying what the limit applies to (i.e. per occurrence).
AIRCRAFT COVERAGES Limit Enter limit: The limit amount for the coverage.
AIRCRAFT COVERAGES Applies To Enter code: The code identifying what the limit applies to (i.e. per occurrence).
AIRCRAFT COVERAGES Deductible Enter deductible: The deductible amount for the coverage.
AIRCRAFT COVERAGES Applies To Enter code: The code identifying what the deductible applies to.
AIRCRAFT COVERAGES Deductible Enter deductible: The deductible amount for the coverage.
AIRCRAFT COVERAGES Applies To Enter code: The code identifying what the deductible applies to.
AIRCRAFT COVERAGES Deductible Enter deductible: The deductible amount for the coverage.
AIRCRAFT COVERAGES Applies To Enter code: The code identifying what the deductible applies to.
AIRCRAFT COVERAGES Coverage Code Enter code: The code for the coverage.
AIRCRAFT COVERAGES Coverage Description Enter text: The description of other coverage (not the limit) on the policy. Any questions about appropriate limits or applicable policy coverage(s) should be answered by the issuing insurer(s)
AIRCRAFT COVERAGES Option Checkbox Check the box (if applicable): Indicates a coverage option applies to the coverage.
AIRCRAFT COVERAGES Option Description Enter text: The description of the option being requested.
AIRCRAFT COVERAGES Option Checkbox Check the box (if applicable): Indicates a coverage option applies to the coverage.
AIRCRAFT COVERAGES Option Description Enter text: The description of the option being requested.
AIRCRAFT COVERAGES Option Checkbox Check the box (if applicable): Indicates a coverage option applies to the coverage.
AIRCRAFT COVERAGES Option Description Enter text: The description of the option being requested.
AIRCRAFT COVERAGES Limit Enter limit: The limit amount for the coverage.
AIRCRAFT COVERAGES Applies To Enter code: The code identifying what the limit applies to (i.e. per occurrence).
AIRCRAFT COVERAGES Limit Enter limit: The limit amount for the coverage.
AIRCRAFT COVERAGES Applies To Enter code: The code identifying what the limit applies to (i.e. per occurrence).
AIRCRAFT COVERAGES Limit Enter limit: The limit amount for the coverage.
 

Section Name Field Name Field and/or Section Description
AIRCRAFT COVERAGES Applies To Enter code: The code identifying what the limit applies to (i.e. per occurrence).
AIRCRAFT COVERAGES Deductible Enter deductible: The deductible amount for the coverage.
AIRCRAFT COVERAGES Applies To Enter code: The code identifying what the deductible applies to.
AIRCRAFT COVERAGES Deductible Enter deductible: The deductible amount for the coverage.
AIRCRAFT COVERAGES Applies To Enter code: The code identifying what the deductible applies to.
AIRCRAFT COVERAGES Deductible Enter deductible: The deductible amount for the coverage.
AIRCRAFT COVERAGES Applies To Enter code: The code identifying what the deductible applies to.
AIRCRAFT COVERAGES Coverage Code Enter code: The code for the coverage.
AIRCRAFT COVERAGES Coverage Description Enter text: The description of other coverage (not the limit) on the policy. Any questions about appropriate limits or applicable policy coverage(s) should be answered by the issuing insurer(s)
AIRCRAFT COVERAGES Option Checkbox Check the box (if applicable): Indicates a coverage option applies to the coverage.
AIRCRAFT COVERAGES Option Description Enter text: The description of the option being requested.
AIRCRAFT COVERAGES Option Checkbox Check the box (if applicable): Indicates a coverage option applies to the coverage.
AIRCRAFT COVERAGES Option Description Enter text: The description of the option being requested.
AIRCRAFT COVERAGES Option Checkbox Check the box (if applicable): Indicates a coverage option applies to the coverage.
AIRCRAFT COVERAGES Option Description Enter text: The description of the option being requested.
AIRCRAFT COVERAGES Limit Enter limit: The limit amount for the coverage.
AIRCRAFT COVERAGES Applies To Enter code: The code identifying what the limit applies to (i.e. per occurrence).
AIRCRAFT COVERAGES Limit Enter limit: The limit amount for the coverage.
AIRCRAFT COVERAGES Applies To Enter code: The code identifying what the limit applies to (i.e. per occurrence).
AIRCRAFT COVERAGES Limit Enter limit: The limit amount for the coverage.
AIRCRAFT COVERAGES Applies To Enter code: The code identifying what the limit applies to (i.e. per occurrence).
AIRCRAFT COVERAGES Deductible Enter deductible: The deductible amount for the coverage.
AIRCRAFT COVERAGES Applies To Enter code: The code identifying what the deductible applies to.
AIRCRAFT COVERAGES Deductible Enter deductible: The deductible amount for the coverage.
AIRCRAFT COVERAGES Applies To Enter code: The code identifying what the deductible applies to.
AIRCRAFT COVERAGES Deductible Enter deductible: The deductible amount for the coverage.
AIRCRAFT COVERAGES Applies To Enter code: The code identifying what the deductible applies to.
NAME & ADDRESS Name & Address Enter text: The additional interest’s full name.
NAME & ADDRESS Enter text: The additional interest’s mailing address line one.
NAME & ADDRESS Enter text: The additional interest’s mailing address line two.
NAME & ADDRESS Enter text: The additional interest’s mailing address city name.
NAME & ADDRESS Enter code: The additional interest’s mailing address state or province code.
NAME & ADDRESS Enter code: The additional interest’s mailing address postal code.
NAME & ADDRESS Mortgagee Check the box (if applicable): Indicates the additional interest type is a mortgagee.
 

Section Name Field Name Field and/or Section Description
NAME & ADDRESS Additional Insured Check the box (if applicable): Indicates the additional interest type is an additional insured.
NAME & ADDRESS Loss Payee Check the box (if applicable): Indicates the additional interest type is a loss payee.
NAME & ADDRESS Other Check the box (if applicable): Indicates the additional interest is not any of the types listed on the form.
NAME & ADDRESS Other Description Enter text: The description of the type of interest in the item.
NAME & ADDRESS Loan Number Enter identifier: The loan number, account number or other controlling number that the additional interest may have assigned the insured.
NAME & ADDRESS Authorized Representative Sign here: Accommodates the signature of the authorized representative (e.g. producer, agent, broker, etc.). by all companies to issue Certificates. This is required in most states. As used here, binders must be signed by authorized representatives of the issuing company.
IDENTIFICATION SECTION Agency Customer Id Enter identifier: The customer’s identification number assigned by the producer (e.g. agency or brokerage).
PILOT INFORMATION Pilot # Enter number: The producer assigned number for the pilot.
PILOT INFORMATION Pilot Name Enter text: The full name of the pilot.
PILOT INFORMATION Registration Number of Assigned Aircraft Enter identifier: The registration number of the aircraft (a.k.a. tail number) to which the pilot is assigned.
PILOT INFORMATION Registration Number of Assigned Aircraft Enter identifier: The registration number of the aircraft (a.k.a. tail number) to which the pilot is assigned.
PILOT INFORMATION Registration Number of Assigned Aircraft Enter identifier: The registration number of the aircraft (a.k.a. tail number) to which the pilot is assigned.
PILOT INFORMATION Registration Number of Assigned Aircraft Enter identifier: The registration number of the aircraft (a.k.a. tail number) to which the pilot is assigned.
PILOT INFORMATION Registration Number of Assigned Aircraft Enter identifier: The registration number of the aircraft (a.k.a. tail number) to which the pilot is assigned.
OPEN PILOT WARRANTY (Carrier normally completes description. Attach ACORD 101, Additional Remarks Schedule, if more space is required) Form Number Enter identifier: The number used by the insurer for this form.
 

Section Name Field Name Field and/or Section Description
OPEN PILOT WARRANTY (Carrier normally completes description. Attach ACORD 101, Additional Remarks Schedule, if more space is required) Form Name Enter text: The name of the form.
OPEN PILOT WARRANTY (Carrier normally completes description. Attach ACORD 101, Additional Remarks Schedule, if more space is required) Description Enter text: The description of the form.
OPEN PILOT WARRANTY (Carrier normally completes description. Attach ACORD 101, Additional Remarks Schedule, if more space is required) Form Number Enter identifier: The number used by the insurer for this form.
OPEN PILOT WARRANTY (Carrier normally completes description. Attach ACORD 101, Additional Remarks Schedule, if more space is required) Form Name Enter text: The name of the form.
OPEN PILOT WARRANTY (Carrier normally completes description. Attach ACORD 101, Additional Remarks Schedule, if more space is required) Description Enter text: The description of the form.
Section Name Field Name Field and/or Section Description
DESCRIPTION OF
OPERATIONS / REMARKS
(Attach ACORD 101,
Additional Remarks
Schedule if more space is Enter text: The Aircraft Insurance Binder general remarks including the description of
required) Description of Operations operations. Attach ACORD 101, Additional Remarks Schedule, if more space is required.
Edition Date The edition identifier of the form including the form number and edition (the date is typically formatted YYYY/MM).